Most of the 20 children killed in the second-deadliest school shooting in U.S. history were first-graders, the state's chief medical examiner said. All had died of multiple gunshots wounds, and the seven he personally examined had been hit with between three and 11 bullets a piece.

"I’ve been at this for a third of the century," Dr. H. Wayne Carver said, "and ... this is probably the worst that I have seen or the worst that I know of any of my colleagues having seen.”

The medical examiners' office provided photos of the victims to families, rather than having families come to identify the bodies in person. "It's easier on the families when you do that," Carver said.

Eighteen females and seven males were killed in the attack. Sixteen of the children were 6 years old, while four were 7.